نشریه مدیریت ارتقای سلامت
سال پنجم شماره 1 (پیاپی 17، زمستان 1394)

One of the major changes in the elderly is loss of teeth، which can affect their dietary intake and nutrition status. This study aimed to determine oral health in older people referred to to selected dentistry schools of universities of Tehran. This descriptive was conducted in 2015 with 188 older people selected randomly from clinics'' dentistry schools in Tehran city. Sampling method was convenience sampling. Data was collected using demographic and density data and “General Oral Health Assessment Index” (GOHAI). Validity and reliability of the instrument were confirmed in previous studies. Data was analyzed using SPSS/21. The mean of “GOHAI” score was 39. 36 ± 10. 72 (in the range of 18-60). The mean of “GOHAI” score in the physical function was the lowest in edentulous without denture wearing group (7. 09. ± 0. 86). The lowest “GOHAI” score in pain dimension was in dentate with partial denture wearing group (4. 43±0. 50). The lowest “GOHAI” score in psychosocial dimension was in edentulous without denture wearing (20. 59 ± 2. 19). There was a significant positive correlation between “GOHAI” and some factors such as education status، income، smoking، brushing، and dental situation. In the lowest “GOHAI” score belonged to the physical function in target group، which indicated that the greatest problem of older people is related to the chewing and biting of foods. The people who lost all of their tooth and used complete or partial removable dentures obtained lower “GOHAI” score. Under such circumstances، routine oral examination as part of health program in older people is recommended.

Necessity to cost manage of hospital as important & operating sector unit of health care system is to gain enough knowledge of economic concepts such as efficiency. The aim of this study was to determine the efficiency in hospitals of Shahid Beheshti University of Medical Sciences with using Data Envelopement Analysis Method. This descriptive-comparative study, measured the efficiency of 12 hospitals at Shahid Beheshti University of Medical Sciences, using Data Envelopement Analysis Method. Inputs’ variables consisted of number of physicians, & nursing staff (Scenario 1) plus number of beds, & bed turnover rate (Scenario 2). Outputs’ variables included function of the operating rooms (Situation 1) and the number of discharged patients (Situation 2). Data were collected by obtaining the recorded documents from Medicine deputy and Hospital’s General Information Form and were analyzed using Deep 2.1 software. The lowest mean of technical efficiency in 2013 was 0.048 & in the first semester of 2014, was 0.194. Hospitals’ number 5 and 6 in 2013 & hospitals’ number 1,2 & 3 in the first semester of 2014 had the maximum efficiency. In hospitals with less than 1.000, efficiency, the inefficiencies factors were related to technical & scale efficiency. Therefore, correcting these two efficiencies lead to optimal efficiency. It is recommended, that these hospitals optimize their surplus from original values to achieve the expected optimal efficiency.

Based on World Health Organization (WHO) report, the prevalence of people with disability is increasing. Community can facilitate the participation of disabled people in the society by providing a suitable modified environment. This study aimed to determine performance of mangers and employers in urban modification for people with disability in the municipality of Tehran. In this descriptive study, data was gathered using two questionnaires of “Assessment of Performance of Managers and Employees in Urban Modification for People With Disability in Municipality of Tehran City” from managers and employees’ point of view. Content validity of the questionnaires were confirmed using Lawasche's method and reliability was determined by Cronbach's alpha coefficient and test- retest method. In total 178 managers and employees were working in modification staff of Tehran Municipality or one of the deputies of architecture, engineering and construction, transportation and traffic of 22 region of Municipality in Tehran City that were selected by census. In addition, 53 people with disability that referred to Red Crescent population or Non-Government Organization of spinal cord disables of Iran that were selected by convenience sampling. Data was analyzed using SPSS/22. Findings showed that 34.8% of people assessed the performance of managers and employees about urban modification in poor level and 29.8% assessed it in the average level. In addition, 54.7% of people with disability mentioned that the performance of managers and employers was poor. In addition, the performance of men managers and employees had better p-value than women (P-V= 0.02). Also, the performance of managers and employees who were familiar with the disability concept was better than those who were not familiar with this concept (P-V= 0.01). Performance of men managers and employees who were familiar with disabilities was better than others in the field of urban modification for people with disability. It is recommended to assess the barriers related to performance promotion of women employees’ and consider strategies to reduce the problems.

Improving quality and safety of hospital services is a challenge for managers. Utilizing an appropriate nosocomial infection management model can improve the quality of safety procedures; quality of care and reduce the nosocomial infections. This study aimed to survey the effect of nosocomial infection management model on reduction of nosocomial infections at Hospital of Jahrom 2014: performing an action research study. The undergone action research study through necessary intervention was performed in 6 months. Two valid & reliable checklists including “Hand Hygiene Checklist “and “Sterilization of Surfaces and Patient Care Units Checklist” were completed and scored before and after the intervention. Data were analyzed using SPSS/22. With the implementation of “Nosocomial Infection Management Model” due to structural problems, infections was increased three times during the last 6 months of this survey compared to similar months in past year. However, implementation of the model decreased the nosocomial infections’ rate by 39% compared to the first three months of the same year. Utilizing “Nosocomial Infection Management Model”, plays a significant role in reducing the nosocomial infections. Hence applying this model in hospitals is recommended.

Social support is very important in women to cope with postpartum stress, to accept the new role, provide a better baby care and maintain the physical and mental health of mothers. The aim of this study was to determine the correlation between postpartum stress and social support in nulliparous women who referred to health centers in Zahedan in 2014. In this descriptive-correlational study, 160 nulliparous women who referred to health center in Zahedan to receive postpartum care were selected through convenience sampling in 2014. Data was collected using the demographic questionnaire, “Postpartum Stress Scale” (PSS) and “Postpartum Social Support”. Content validity and reliability of the questionnaire were measured by Cronbach’s alpha. Data was analyzed by SPSS/18. There was a significant inverse relationship between social support of mothers and postpartum stress score (P=0.0001, r=-0.62). According to regression analysis, the score of social support, duration of marriage, newborn gender and ethnicity in total show a 55 percent variation in postpartum stress score. Social support, duration of marriage, newborn gender and ethnicity have an important role in predicting postpartum stress. Therefore, enhancement of social support in postpartum care programs is suggested.

In recent years, health authorities have implemented various methods to improve the quality of services and safety of patients. The aim of this study was to determine accreditation measures with clinical governance orientation using “Balanced Score card” Approach in Sarem Women’s Hospital. In this descriptive study, 80 staff of Sarem Hospital were selected through a random sampling. To collect data, the “Balanced Scorecard” and “Clinical Governance” questionnaires were used. The content validity of the questionnaires was confirmed by 10 experts from medical staff, accreditation experts, and senior managers. In order to test the questionnaires’ reliability, 20 participants from clinical and non-clinical staff and experts in Sarem hospital were responded to pilot questionnaire that achieved satisfactory Cronbach's Alpha. To analyze the data, SPSS/22 and excel were used. 54 indicators for accreditation measures with clinical governance orientation were determined. Also according to the Pierson correlation test, the results showed that “clinical audit” indicators and “financial” perspective, “patient and community participation” indicators and “customer” perspective, “clinical effectiveness” indicators and “internal process” perspective, and finally “use of information and development” and “training and staff management” indicators and “growth and learning” perspective are correlated. However, “appropriateness of the risk management” indicators and “customer perspective” was not correlated. In this study, 54 accreditation indicators with clinical governance orientation were identified. Relationship between clinical governance indicators and Balanced Scorecard perspectives contributes to reduction of the complexity of hospital accreditation concepts. It is recommended that hospital administrators use the indicators to facilitate implementation of accreditation.

Mental health is one of the most important factors in promotion of human evolution. People who are good at managing their own and other's emotions have more social support and satisfaction. The aim of this study was to determine correlation between emotional intelligence and mental health among students of Jiroft city. This study is a descriptive-correlational study. Which was conducted on students in universities of Medical Sciences, Azad and University of Jiroft in 2013. In total 674 students were selected by Stratified Sampling method. Three questionnaires of demographic characterizes, “Emotional Intelligence Questionnaire Bradbry and Graves” and “General Health Questionnaire” (GHQ) were used to collect data. To measure validity, content validity and reliability of the questionnaires test-retest was used. Data was analyzed by SPSS/17. In total 394 subjects (58.5%) were suspect of mental health problems. The regression logistic showed that there was correlation between mental health and gender (P=0.008), mental health and residence status (P=0.036). However, the correlation between mental health and university of study and marital status was not significant. The average score of EQ was 92.07±15.29. Regression analysis indicated a significant association between mental health and self-management variables (OR=0.937, P=0.002) and social consciousness (OR=0.917, P<0.0001). Spearman test showed a significant correlation between mental health and EQ (r= 0.238, P<0.0001). The results of this study reflects the positive correlation of emotional intelligence on mental health. It is suggested that planning and training the emotional intelligence is a step to promote students mental health.

Today, the emergence of high-risk behaviors, influenced by sociological factors and parenting approaches, among youth has turned into one of the most important issues in the society. The aim of this study was to determine correlation between risky behaviors in the pre-university adolescent students in Hamadan with Parents’ child raising method. This is a descriptive study which was conducted in pre-university school students in 2012-2013. A sample of 220 students (120 boys and 100 girls) was chosen via the random multi-stage cluster sampling method. For data collection, “Baumrind’s Parenting Style Scale” and “Iranian Adolescents Risk-Taking Scale” were used. Validity of the scales were confirmed by 8 psychologists and psychotherapists experts. Reliability of the scales were measured by Cronbach‘s alpha and test-retest methods. Data was analyzed by SPSS/21. Findings showed a significant and negative correlation between student's high-risk behavior, authoritative parenting, and the parent's educational level (P<0.001, r=-0.42 & P<0.001, r= -0.48). There was also a significant difference between male and female students in the frequency of the emerging high-risk behaviors (P<0.05). The high-risk behaviors among male students (3.34) is significant more than female students (2.68). However, there was no significant difference between economical-social classes and student's high-risk behaviors. Parenting approaches, parent’s educational levels, and gender types are influential factors in the occurrence of high-risk behavior. Therefore, providing the adequate training for parents, to obtain right a parenting approach, is recommended.

Among all age groups, young people are one of the most risky groups. Hence health-related behavior promotions can reduce exposure of this group to the risk factors. The aim of this study was to determine the effectiveness of health promotion intervention on health-related behaviors in university students. The method of this study was quasi-experimental. In total 30 students from psychology, educational sciences and knowledge and information Science from faculties of Psychology and Educational Sciences of Semnan University were selected through convenience sampling method. Then the subjects were randomly assigned to two groups of intervention (15 persons) and control (15 persons). Data was collected using “Health Promotion Lifestyle Profile-II”. Face and content validity were confirmed by two health psychologist and two psychometric and reliability of the instrument was obtained through internal consistency and test-retest method. The experiment group received 10 educational sessions. Evaluation was conducted at pre-test, post-test and follow-up stages. Final data were analyzed using SPSS/22. The health promotion intervention had statistically a significant effect on improvement of college students health-related behaviors in post-test (54.07±9.88) and follow-up (50.73±8.07) than pre-test (69.27±13.12) for intervention group compared to control group (F= 16.224, and P≤0.001). The effect size was 0.375. Health promotion intervention can increase healthy behaviors in college students and protect them against risky behaviors. To reduce risky behaviors, educational health-promotion intervention programs are suggested.

Studies have shown common risk factors between coronary heart diseases, periodontal and erectile dysfunction. The most important factors contributing to such diseases are psychological factors. The aim of this study was to determine the effect of psychological factors on correlation between periodontal diseases and erectile dysfunction in CHD patients. This descriptive-correlational study was carried out in 2014 in which 31 CHD male patients whom referred to Mehr Clinic in Tehran were selected by convenience sampling. Data were gathered by four questionnaires namely “Depression Anxiety Stress Scale”, “The International Index of Erectile Function”, “Florida Sexual History Questionnaire” and “CPD Self-Check Sheet”. The content validity of these instruments, based on their content validity were measured and reliability was confirmed using Cronbach’s alpha method. Data were analyzed by SPSS/19. In total, 74.2% of patients had organic and 25.8% had psychogenic erectile dys-function. In addition, no significant correlation was observed between periodontal disease and erectile dysfunction. Furthermore, only stress had an effect on this correlation. Results are showed that anxiety could predict the type of erectile dysfunction (P-value<0.05). There was no correlation between periodontal disease and erectile dysfunction in CHD patients. It is suggested that patients with both organic and psychogenic impotence, be evaluated for stress, anxiety and depression as well as periodontal disease with more compre-hensive questionnaires. Additionally, such study can be carried out on higher number of CHD patients to allow generalizability of the findings.